Firstly my eldest daughter, Katie, had been pestering me
for years to organise the various photographs and other
documents that I retained from my time in 55FST. Clearly the
material was not suitable for assembly into any sort of
ring-binder but would lend itself to a website or DVD.

The range and scope of the website has grown incrementally as
some of the other units that were in Dhofar at the time have
added their contributions. Documentary material that was not
available at the time has now been made available at the PRO in
Kew and repeated visits there have proved fruitful. Much
guidance has come from references in the back of books where
authors have done their research. Thankyou!

It also
transpired that much of the documentation about the FSTs, if not
all of it, had gone
astray in the middle to late 90's, when the RAMC HQ Mess in Millbank was closed and the move was made from London to Mytchett.
A great deal of material had been shredded and was beyond reach. It
seemed important to seek out any documents relevant to 55FST and
make them available on the internet. Once the website was
established and people began to log on with a steady trickle of
reminiscences and all manner of documents have been accumulated. They
tend to appear
once every two or three months but all are valuable addition to
the record.

The contribution made by medical services is rarely
acknowledged. Detailed descriptions of battles are commonplace
but the "butcher's bill" rarely had a mention other than in
simple figures of so many killed or wounded. Thatis until the recent
conflict in Afghanistan. Footage of the hospital at Camp Bastion
has now been seen on the television, details of wounded soldiers
being rehabilitated at facilities such as Headley Court are
commonplace and of course coffins being carried through Wootton
Bassett were, tragically, almost a daily occurrence. The records of
55FST gave the opportunity to record what went on just behind the front line
nearly forty five years ago.

Secondly, in the autumn or late summer of 2004 I saw a
television programme about a Field Hospital in Iraq. One clip
hit a slightly raw nerve. A surgeon was standing in front of a high
tech anaesthetic machine which was festooned with variety of
anaesthetic gas
bottles and he was suggesting that the patient that he had just
seen should now be dealt with by the unit neurosurgeon.

The circumstances were so different from my experience. A single
FST comprising 13 people in Oman in the 70's cannot be compared
with the recent large scale medical provision in Afghanistan. In
a "light" FST close to the front line the surgeon and the
anaesthetist did not have the luxury either of complex
investigations, discussion with a range of colleagues or of
ideal resuscitation equipment. The immediate problem had to be
sorted out instinctively and quickly before the next laden
helicopter arrived and saturated the capacity of the team. The
war in Dhofar and modern day campaigns developed into what is
now loosely termed "asymmetric warfare" with the opportunities
to create static medical services in relatively safe
environments. The concept of deploying surgeons forward has
changed. The provision of a trained medic to secure the
airway and begin iv therapy on the way back to the sophisticated
surgical facility was the first step. Combat Medical Technicians
have become the norm. Best practice in Afghanistan with the
Medical Emergency Response Teams brought not a surgeon but a
consultant anaesthetist to the casualty in a Chinook. Forty years ago we , by force of
circumstances, had to employ what is now termed DCS - Damage
Control Surgery - as soon as possible. Modern best practice uses
oxygen, blood, clotting factors and other measures early on to
achieve their excellent results. In the absence of such
facilities the faster the damage and bleeding was limited seemed
the obvious route to take.

Even though I had not touched an anaesthetic machine since soon
after leaving Salalah I knew that, from my own experience, the chances of an efficient supply of gases
for an anaesthetic machine was probably
“pie in the sky”. The supply of anything in a remote bit of
desert was and may still be, at best, uncertain.

The present day provision of medical care and the degree of sophistication
is of the highest order and great credit is due to those who set
it up and manage the huge range of services that it offers.
Unless there has been a sea change since the 70's I believe
that reliance upon a long chain of supply and resupply could
still be
a problem. The ordering and supply of surgical and medical
materials electronically should in theory be very efficient. In
practice there are many opportunities for links in the chain to
fail and the more complex the databases of required materials
the more opportunities for failure.

The Haloxaire anaesthetic machine was a simple robust bit of kit which, with the
occasional use of oxygen and a limited portfolio of drugs, did
what it "said on the tin". It was easy to use and did not require
an anaesthetist of any great experience to operate it. Halothane
has its disadvantages however and is not a strong analgesic,
tends to drop the blood pressure and depresses respiration. Following
on from the Haloxaire the design and development of the
TriService Anaesthetic apparatus was another step forward. It
did however sometimes require the provision of a mechanical
ventilator and often used a combination of two inhalational
anaesthetics from two vapourisers. Some of the simplicity of the
Haloxaire was lost and it perhaps required a more skilled
anaesthetist than the short service medical officer. It was a
very versatile setup and could be used in a variety of ways
giving it distinct advantages over the Haloxaire especially in
the hands of an experienced anaesthetist.

I would suggest that
whilst it is important to have highly trained experienced
anaesthetists there is also a need to have "short service
anaesthetists" who can cope with the less complex and demanding
anaesthetics. The KISS principle applies and might very well
both overcome any shortages of men and materiel and provide a service where resupply
of either was a problem. There is an obvious application for
these simpler techniques in the violent conflicts that have
arisen within nations as a result of the violence following the
"Arab Spring".

The experience in
Dhofar would suggest that whilst small under resourced teams,
trained to use simple equipment and work around deficiencies,
will certainly not replace the sophistication of a Role 2
surgical facility, they could do an immense amount of good in
the circumstances that have arisen in Libya and Syria in recent
times. Perhaps service medical personnel should be trained in
those techniques, not in the expectation that they might use
them, but in order to train others in those skills who may have
need of them ?

One may reflect on whether the outcome for patients treated at
the vastly more complex present day field hospitals - Role 2
facilities - with their
large numbers of highly
trained and specialist staff is significantly
better than that at 55FST back in 1972?
We only saw a tiny number of patients in Dhofar and none of the casualties
had the multiple limb amputations or severe blast injuries that have occurred in
Afghanistan. As time has
gone by it seems to be clear that the lives of very severely
wounded soldiers in Afghanistan, who would not have survived in Dhofar, are now being saved
- the "unexpected survivors". Whilst the
crude survival rates may not
be
statistically very different - no like for like comparison can
be made - the increased morbidity for so many
soldiers from these savage wounds in this recent conflict is significantly greater.

The contribution to the war by the FST was considerable. Walter
Ladwig III comments in his paper on the war : -

"Their contribution to the morale of the whole force was beyond
price. The knowledge that anyone who was hurt would be flown to
Salalah for expert surgery and resuscitation, usually within
half an hour of being hit, must have been a factor in the
bravery shown by so many people"

Following the attack on the Officers' Mess at RAF Salalah
praise came from both the SAF commander and from SOAF. Rather
curiously BATT acknowledged our contribution 37 years later when
they made a personal presentation at their annual Regimental
Association meeting in 2009.

The enigma remains however of the interest
or lack of it taken by the MOD in the RAF Salalah FST. This FST
was the only active service FST that the UK armed forces had
operating at that time.
The
RAF ORB 540s for 1971 to 1975 record
all the significant visitors transiting RAF Salalah. The only
senior RAMC visitors were Lt Col Moffatt in February 1975 in his
capacity as DDMS, and then Col Lawrence an ADMS with NEARELF in
February 1975. The RAF did not fare so well; Air Cdre McIntosh
PMO NEAF in July 1975.

In the slightly strange book "Operation Storm"
by Cole and Belfield it is recorded that emphasis had
been placed on the provision of a well resourced FST with excellent casevac
arrangements. It is a slightly odd comment as one might expect excellent
surgical backup as standard provision when any number of troops were
deployed. Yet for some reason that comment is made in the book. The
promise must have been made. The RAMC did provide limited medical staff
but did little to ensure the
adequate provision of equipment or
suitable medical accommodation. MOD apparently then took scant interest in the progress of
the enterprise. Two visits by senior RAMC officers in five years
is not exactly impressive and compares very unfavourably with
other corps and regiments who had members in Dhofar.